Siblings charged with fraud

BOSTON 
Two Wachusett area residents are among eight people charged with defrauding the stateís Medicaid program of about $260,000 by falsely billing for services the state claims were not provided.

Marcy Keegan Grenache, 32, of West Boylston, and her brother, Daniel Keegan, 30, of Holden, were indicted by a Worcester County grand jury Tuesday alleging they billed MassHealth for more than $93,000 for services not provided.

Five former personal care attendants and three surrogate caregivers have been charged. In one case, the state was billed for MassHealth services while the personal care attendant was incarcerated. In another, the state was billed for care of a person who was no longer living. The cases were presented to grand juries seated in Worcester, Hampshire and Hampden counties.

Ms. Grenacheís disabled son had been approved to receive PCA care in 2007 and acting as his surrogate Ms. Grenache hired Mr. Keegan as her personal care attendant in October 2007. For a period that ended in October 2011, the two allegedly submitted fraudulent timesheets for services the state alleges could not have been provided because Mr. Keegan lived outside of Massachusetts at that time, traveled extensively and maintained conflicting employment.

Although Mr. Keegan divided his time between Florida and Tennessee, timesheets were submitted for payment on a bi-weekly basis for three and a half years, state officials said.

After the funds were deposited into Mr. Keeganís bank account, large sums were transferred to Ms. Grenache by check. MassHealth paid $103,000 for services billed under Mr. Keeganís name, but investigators said more than $93,000 of that sum was for services he never provided.

Both were indicted on one count of Medicaid false claims and one count of larceny over $250. Both are scheduled to be arraigned March 5 in Worcester Superior Court.

In another case, the Worcester grand jury indicted Alan Morrissette, 53, and his wife, Jacqueline Morrissette, 55, of Blackstone, for three alleged false billing schemes, all of which involved the consumers not being present in their homes.

The case was referred to the attorney generalís office by the state Auditor Bureau of Special Investigations after Mr. Morrissette was identified as the highest paid MassHealth PCA in the state, earning more than $100,000 from the program. His wife allegedly assisted him in obtaining money for the PCA services that were never provided by co-signing timesheets as the surrogate for two MassHealth members who live in their home.

The state alleges in one scheme from 2007 to 2010 the Morrissettes submitted timesheets for PCA services for a consumer who was at a day habilitation program 10 miles away. Another case involved submitting timesheets and being paid for services for MassHealth members who were hospitalized at the time. The indictment also alleges the two submitted timesheets for 32 days while a MassHealth member was an in-patient at a residential care facility.

In another case in Hampshire County, the grand jury indicted James Lynch, 43, of Agawam, and Holly-Beth Riopel, 37, of Palmer, for allegedly billing for services provided while he was working as a bus driver for the Lower Pioneer Valley Educational Collaborative and also for inflating timesheets. Ms. Riopel, a teacher for the Palmer public schools, was also charged for allegedly billing for PCA services not provided.

In a case out of Holyoke, Amerilis Pirela, 33, was indicted for allegedly submitting timesheets for PCA care provided by her brother who was in jail at the time for illegal possession of a firearm and ammunition. Ms. Pirela was also charged with billing for PCA services for a MassHealth member who was deceased.

A criminal complaint was also issued by the Boston Municipal Court charging Abel Vega, 29, of Jamaica Plain, for billing for PCA services for a MassHealth member who was a patient at a hospital and later at a long-term care facility.